Comparison of Different Biologics for Treating Chronic Rhinosinusitis With Nasal Polyps: A Network Analysis.

Abstract

BACKGROUND:

Several promising clinical trials have demonstrated the effects of type 2 biologics compared with placebos in chronic rhinosinusitis with nasal polyps (CRSwNP). However, there are no head-to-head randomized controlled trials (RCTs) between the biologics.

OBJECTIVE:

To compare the efficacy and safety of different biologics used for the treatment of CRSwNP.

METHODS:

We systematically identified RCTs investigating the effects of biologics for CRSwNP. Primary outcomes were nasal polyp score (NPS), nasal congestion severity, and serious adverse events. Secondary outcomes included the 22-item Sino-Nasal Outcome Test (SNOT-22) score, loss of smell severity, the University of Pennsylvania Smell Identification Test score, and the Lund-Mackay computed tomography score. Bucher indirect treatment comparison (ITC) was used to compare the outcome parameters.

RESULTS:

Seven RCTs (Bachert 2017, OSTRO, POLYP 1, POLYP 2, SINUS-24, SINUS-52, and SYNAPSE) involving 1913 patients and 4 biologics (benralizumab, dupilumab, mepolizumab, and omalizumab) were included for ITC. Dupilumab presented better effects in decreasing NPS and nasal congestion severity compared with the other 3 biologics at 24 weeks of the treatment and at the end of follow-up (more than 48 weeks). Benralizumab was the least effective in reducing nasal congestion severity and SNOT-22 score at 24 weeks. No significant differences were observed between the effects of the other biologics.

CONCLUSION:

Our current findings suggest that dupilumab exhibits the best efficacy and safety for the treatment of CRSwNP.

• Authors: Shiru Cai, Shenglong Xu, Hongfei Lou, Luo Zhang
• Journal: The journal of allergy and clinical immunology. In practice (J Allergy Clin Immunol Pract) Vol. 10 Issue 7 Pg. 1876-1886.e7 (07 2022) ISSN: 2213-2201 [Electronic] United States
• PMID: 35272073 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Biological Products

Topics

• Biological Products (therapeutic use)
• Chronic Disease
• Humans
• Nasal Polyps (therapy)
• Quality of Life
• Rhinitis (therapy)
• Sinusitis (therapy)